Psychosocial Assessment, Support and Counseling

 

The Genetic Counseling Session

Interpersonal, counseling, and psychosocial assessment skills form a central core of genetic counseling professional practice, as delineated in the ABGC Practice-Based Competencies. These skills include: establishing rapport, identifying major concerns and responding to emerging issues of a client or family; eliciting and interpreting individual and family experience, behaviors, emotions, perceptions and attitudes that clarify beliefs and values; ability to use a range of interviewing techniques; ability to provide short-term, client-centered counseling and psychological support; ability to promote client decision-making in an unbiased, non-coercive manner; ability to establish and maintain inter- and intra-disciplinary professional relationships as part of a health care delivery team. Psychosocial assessment is a personalized and ongoing process throughout the session aimed at understanding, enabling and empowering the client, and facilitating development of plans for medical care and family support (Videbeck, 2007), family communication, reproductive decision making, genetic testing, etc. An effective psychosocial assessment personalizes the session to help determine the unique needs of the patient. Identifying the patient’s unique concerns and providing appropriate responses can be complicated by limited time and the large amount of content that must be communicated to the patient. Yet, when the pertinent psychosocial issues are left unattended, the effectiveness of the genetic counseling session is compromised, ultimately hindering decision making and family coping. These challenges pertain to all genetic counseling sessions, irrespective of cultural factors or differences.

Building Rapport

The relationship-building interactions between the counselor and client can determine the success or failure of the interview as a psychosocial assessment tool. Clients will respond more favorably to counselors who are responsive to their preferences. Establishing rapport is important because it not only makes the client feel comfortable, but it also makes the counselor feel comfortable. Anxiety and unease can cause a counselor to be more self-focused than client-focused. When this misplaced focus is overcome, the counselor can be more empathetic, more attentive to nonverbal cues, more available to “hear” emotional content, and less concerned about being personally overwhelmed by their patients’ distress (Borders et al., 2006).

►Exercise

Consider the following suggestions and brainstorm additional ways that minor actions can impact the “success” of a session.

  1. Invite clients to bring along anyone they wish to the counseling session, as some cultures involve extended family members in the decision making process.

  2. Use movable chairs so that personal space can be adjusted according to client preference. Allow client(s) to seat themselves first.

  3. Clarify how the client would like to be addressed and/or how to correctly pronounce his or her name.

  4. Emphasize confidentiality.

  5. Tell counselees that they may share whatever information they feel comfortable contributing.

  6. Identify and convey respect for social hierarchies.

 

Pages: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16